Anatomical characteristics, clinical features, and risk factors of spina bifida: A retrospective review of children at Cure Hospital, Uganda.

Background: Spina bifida, a neural tube defect, continues to pose substantial public health challenges in Uganda despite multiple preventive efforts. An estimated 1,400 children are affected annually. We conducted a retrospective cross-sectional review of hospital records for children diagnosed with spina bifida between 2020 and 2023. Methods: Using systematic sampling, we selected 414 patient records. We analysed the data using SPSS version 20. We defined severe spina bifida as a lumbosacral lesion presenting clinically with hydrocephalus. Results: Males constituted 60.4% of cases (n=250). Infants aged <1 year comprised 36.2% (n=150). Most lesions (69.0%) were located in the lumbosacral region; sacral lesions accounted for 17.4%, lumbar 8.0%, lumbothoracic 4.6%, and occipital and cervical regions 0.5% each. Regarding lesion integrity, the highest proportion of intact lesions occurred in the lumbosacral region (48.1%), followed by sacral (16.2%), lumbar (15.2%), and lumbothoracic (12.4%); ruptured lesions were also observed in the thoracic region (7.8%). Maternal febrile illness was associated with severe spina bifida (adjusted OR 2.24, 95% CI 1.34–3.74; p=0.02). Tertiary maternal education was also associated with higher odds of spina bifida (adjusted OR 2.27, 95% CI 1.43–4.57; p=0.01). Conclusion: Myelomeningocele remains the predominant form of spina bifida in Uganda, chiefly affecting the lumbosacral region.